Medical Oncology Department, Institut Gustave Roussy, Villejuif, France.
Eur J Cancer. 2011 Sep;47 Suppl 3:S272-83. doi: 10.1016/S0959-8049(11)70173-3.
Small-cell lung carcinomas (SCLC) represent 15-18% of all lung cancers. As SCLC has a high propensity for early metastatic dissemination, less than a third of patients have limited disease (T0-1N0-3M0). The new TNM classification should now be used also for SCLC. Platin- and etoposide-based chemotherapy is the cornerstone treatment. Response rates to both chemotherapy and radiotherapy are impressive but relapses are frequent. The current state-of-the-art treatment for MO patients involves platin-etoposide-based chemotherapy, combined with early thoracic radiotherapy. Because of the high risk of brain metastases, prophylactic cranial irradiation is indicated in responders and should be part of the standard management. The 5-year survival rate may reach 25% in MO patients, but does not exceed 10% at 2 years in metastatic patients. Most patients relapse within the first two years, and there are few treatment options in second line as opposed to NSCLC. Many issues are subject for further clinical research such as the biology of this disease to better identify pathways that could be targeted with new drugs, optimisation of systemic treatments and radiotherapy. Pursuing clinical trials at all stages constitutes a challenge for thoracic researchers and oncologists.
小细胞肺癌（SCLC）约占所有肺癌的 15-18%。由于 SCLC 具有早期转移扩散的高倾向，不到三分之一的患者患有局限性疾病（T0-1N0-3M0）。新的 TNM 分类现在也应适用于 SCLC。基于铂类和依托泊苷的化疗是基石治疗。对化疗和放疗的反应率令人印象深刻，但复发率很高。目前 MO 患者的标准治疗方法是基于铂类和依托泊苷的化疗，结合早期胸部放疗。由于脑转移的高风险，应答者应接受预防性颅脑照射，并应作为标准治疗的一部分。MO 患者的 5 年生存率可能达到 25%，但转移性患者 2 年内不超过 10%。大多数患者在头两年内复发，二线治疗选择很少，与 NSCLC 相比。许多问题需要进一步的临床研究，例如这种疾病的生物学，以更好地确定可能用新药靶向的途径，优化全身治疗和放疗。在所有阶段进行临床试验对胸科研究人员和肿瘤学家来说都是一个挑战。
